COVID-19 Community Response Fund Application

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Welcome to the COVID-19 Community Response Fund Application. To apply for funds, please fill out and submit the form below. Once our team has reviewed your application, we will get back to you.

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Please correct the field(s) marked in red below:

1

Name of Organization

2
CRA #
3
Your name
4
Your telephone number
5
Your email address
6
How has COVID-19 impacted your programs and/or services?
7
What is your organization's current, immediate need, including the dollar amount you are requesting?
8
Are you receiving any other funding to help support this immediate need?
Are you receiving any other funding to help support this immediate need?
9
If you answered "Yes", what funding have you received?
10

Please describe the program and your plan for delivery of service.

11

How many individuals need access to this service/program?

12

What is the demographic you will be serving?

13

If you qualify for immediate financial assistance, do you agree to track and report back to United Way with the number of individuals and demographic that benefited from this financial assistance?

If you qualify for immediate financial assistance, do you agree to track and report back to United Way with the number of individuals and demographic that benefited from this financial assistance?
  1. To receive a copy of your submission, please fill out your email address below and submit.
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